Allergens and Food Additives, Including Potentially Harmful Ones, Present in Food Products that Are Preferred By Children and Adolescents

Abstract Introduction The proper development of a child is linked with proper nutrition, including nutritional habits which are formed from childhood. The aim of the study The aim of the study was to establish a list of the most popular food products among children and to develop a register of potentially dangerous substances on a Facebook website. Materials and methods A website was created on Facebook. The participants provided lists of favorite dishes or products. Results The study involved 264 participants. An inverse correlation was observed with reference to the age of the subjects and the occurrence of sugar syrup in their diet (R=-0.20; p<0.001), glucose-fructose (R= -0.18; p< 0.004), and glucose (R=-0.13; p< 0.039) syrups. The most common potential food allergens are: gluten (R=0.28; p<0.001), eggs (R=0.28; p<0.001), and wheat (R=0.25; p<0.001). The main substances added to food that are present in a child’s diet that increase proportionally with reference to the child’s age are: salicylates (R=0.37; p<0.001), iron and ammonium sulfates (R=0.21; p<0.001). Conclusion The choices of favorite products are related to age and sex. Products containing gluten, the consumption of which increases with age, carry a risk of undiagnosed celiac disease and non-celiac gluten sensitivity in people with a genetic predisposition. Facebook has fulfilled its role as an effective tool for gathering information about the food preferences of children and adolescents.

Słowa kluczowe: nawyki dzieci, substancje potencjalne szkodliwe, żywność DEV PERIOD MED. 2017;XXI,2:131ͳ138 A balanced diet is most important when a child is growing and maturing [1]. During this time, the need for nutrients is the highest [2,3]. e amount of nutrients and their proportions in a child's diet is carefully regulated by national nutrition societies. In Poland this role is ful lled by the Polish National Food and Nutrition Institute.
Farming techniques in relation to both plants and animals as well as the methods of food production involve substances (such as preservatives and dyes) that could be harmful for the organism or that have an allergenic potential [4,5]. e RAK Foundation for Nutritional Awareness is responsible for the monitoring of such substances. It is a worldwide organization that aims to raise the awareness about nutrition and spreading information about potentially harmful substances. Its database includes over 100 000 food products. Every entry has a description of allergens and harmful or controversial ingredients added to a given food product (www.foodfacts.com).
Children's eating preferences are developed on the basis of genetic and environmental factors [6]. Children are good at learning and accepting new tastes and food products [7,8]. During kids' rst years of life parents play a key role in the development of their child's eating preferences [9]. When children become older, their taste is more and more in uenced by their peers and the media [10]. e latter include a large number of advertisements, special TV channels and websites that signi cantly in uence children [11]. Nearly all food companies and fast food restaurants have websites with links to products for parents, children and teenagers [12,13]. Food companies that are recognized all over the world o en support sports events and the most popular sportsmen advertise their products [12,14]. is phenomenon strengthens the positive image of these companies [15]. It has been proven that with age children get better at recognizing the labels of food companies [11].
e Internet is one of the most important methods of communication for children and teenagers. e fast and unlimited access to information granted by the Internet gives it a signi cant advantage over traditional media, such as the press, TV or radio. Young people want to be independent in their search for new and interesting information and they want to do it at a time and place convenient for them. Traditional ways of using the Internet (browsing websites in search of information, etc.) are being replaced by social media websites that gather thousands -if not millions -of people with similar interests and expectations and that make it possible to create new information which is shared and used in lively discussions [16,17].

THE AIMS OF THE STUDY
e aims of the study are: -to create a list of products that are most willingly consumed by children and teenagers; -to create a list of typical allergens and possibly harmful substances present in the products that are preferred by children.

The group studied
A group called "Babyshambles children Top 10 favorite food choices" was created on Facebook. 263 people took part in the study. ey sent data on their favorite meals through the social media website. e participants were between 1-18 years old (tab. I). e study included 158 responses written by girls (or their parents), and 105 responses written by boys (or their parents). e study protocol was approved by the ethics committee of the Pomeranian Medical University and conformed to the ethical guidelines of the 1975 Declaration of Helsinki.
2. Data collecƟon and the verificaƟon of potenƟally harmful substances e participants (or their guardians), who had a Facebook account, sent their responses by electronic means providing the following information: their names, age, and a maximum of 10 of their favorite dishes or food products. A table of potentially harmful dishes and food products was created by means of Microso Excel. e analysis of the harmful food additives in the speci ed products was carried out with the help of the data included in the RAK Foundation for Nutritional Awareness' database. If a particular dish or product was not described in the database, its content was analyzed on the basis of its label or the typical content of a dish. If the product or dish included potentially harmful substances, they were included in the database.

StaƟsƟcal analysis
e relationships between each variable were analyzed by means of Spearman's rank correlation coe cient and descriptive statistics. e value p≤0.05 was considered statistically signi cant. e results were developed by means of Statistica 10 (Statso Poland).
The consumpƟon of potenƟally harmful substances in relaƟon to gender e analysis shows that boys (13%) more o en than girls (5%) are exposed to products that include butylated hydroxytoluene (BHT) (R=0. 13   did not provide information on the potentially harmful substance that would be characterized by higher preference in the group of girls (tab. III).
Preferences in relaƟon to the age of the children ere was a positive correlation between the age of the children and their preference in relation to products and dishes that included gluten (R=0.28; p<0.000), and products and dishes that included wheat (R=0.25; p<0.000) − table IV. A positive correlation in reference to age was also observed for dishes and products that included eggs (R=0.28; p<0.000005), mustard plant (R=0.204; p<0.001), chili (R=0.200; p<0.001), and soy (R=0.171; p<0.005). e largest amount of soy products and dishes

Percent of populaƟon Girls
Odsetek    e analysis of correlations between gender and potentially harmful substances yielded interesting results. Among boys the results pointed to signi cant amounts of BHT, sesame, and palm oil. In the boys' diet, a popular brand of chocolate corn akes and chewing gum seem to be the sources of BHT, whereas sesame and palm oil were present in such products as halva, cookies, hamburgers, and toast. Girls preferred dairy products (eggs), and any dishes that included eggs: "paszteciki" (special pastries, i.e. deep-fried dough stu ed with meat or vegetarian lling), dumplings, cakes, croquettes, "pierogi" (a Polish type of dumplings), wa es, "knedle" (a di erent Polish type of dumplings), "łazanki" (a type of pasta dish), "kopytka" (a type of potato dumplings), pancakes, and other starch dishes. e results of this study correspond to those of Japanese scientists who in 2014 carried out an experiment referring to the di erences in the nutritional preferences of school-age children in relation to gender. e study showed that boys have a greater preference for fat than girls [18]. e study of 2014 proved that childhood preferences are in uenced by genes and the people around the children. e latter strongly develop preferences towards products of high energetic density and those that include starch [19]. e analysis of correlations between the content of the children's favorite foods and their age also yielded interesting results. Younger children preferred products that included glucose-fructose syrup, glucose syrup, sugar syrup, vanilla aroma, hazelnuts, and cocoa paste. ese were usually ready-made products of popular brands which were high in calories and had little nutritional value: homogenized cheese, yoghurts, candy, lollipops, croissants, chocolate, sweet drinks, and chocolate butter. ese products are widely advertised on every TV channel. Commercials of highly processed foods o en aim directly at children [20]. Frequently the main characters of these commercials are cartoon heroes or popular sportsmen. e child may want to follow the characters' example and persuade his or her parents to buy the advertised products [21]. In this way, the correlations between the content of allergens and the age of children can be explained. It is also worth mentioning that the participants of this study directly pointed out speci c names of food products. A er the examination of the labels of these products it turned out that most of them are manufactured by a single, well-known company [11,15,20].
Older children preferred dishes and food products that included calcium disodium EDTA (E 385), sodium glutamate, soy, preservatives (sodium benzoate and potassium sorbate), sulphates of ammonium and iron, starch, eggs, salicylates, and chili. Sodium glutamate was present in dishes served at Chinese restaurants. EDTA (E 385) in mayonnaise, which is widely used in many types of fast food. It seems that in this case the positive correlation is not accidental, either. e preference for the consumption of these dishes and food products starts to increase when the child goes to school (starting at the age of 7). Both the environment and the child's peers may have a signi cant in uence on this phenomenon. At this age children face a new reality and new challenges appear. e analysis of the data showed that the top 10 favorite dishes and food products were: French fries (27%), chocolate (27%), pizza (23%), chicken (21%), bananas (20%), tomato soup (19%), pancakes (17%), spaghetti (17%), apples (16%), and sh (16%). Fast food products were high on the top 10 list ( rst place -French fries 27%, third place -pizza 23%. e results correspond to those reached by Polish scientists [21]. In that study fast food products were ranked second on the list of favorite foods. e same study revealed that most children consider frequent visits at popular fast food restaurants very pleasant, because the food is tasty and their parents allow them to choose what they want to eat. In this case we see an element of child independence [21]. One of the most favorite food products consumed by children and teenagers was chocolate (26%). e anticipated high position (second place) of chocolate can be the result of an innate preference for the sweet taste [8]. e younger the age group, the larger the number of products that included the following ingredients: vanilla aroma, glucose-fructose syrup, glucose syrup, and sugar syrup [22]. e early introduction of products that are high in calories and low in nutritional value is a very disturbing phenomenon in the light of the widespread obesity which is now becoming a global epidemic [23].
Among the top ten favorite dishes and food products there was also a place for fruit [24] -in our study bananas were ranked h, and apples ninth. In a similar study in Poland -most children (92%) preferred apples most of all the mentioned types of fruit [22]. Others Polish authors also revealed that apples were the most frequently consumed type of fruit [24]. It is also worth mentioning that among the favorite products chosen by the participants there were no raw vegetables (as a separate food product or in the form of salads). 17.5% of the participants prefer tomato soup (sixth place on the list).
As suggested by the EFSA Panel on Dietetic Products, Nutrition, one should eat two portions of products that are a source of protein (meat, sh, eggs) [25]. Descriptive analysis revealed that 16% of the participants liked sh (with salmon being mentioned most frequently). ere were no statistically signi cant di erences in relation to the preferences of sh consumption and the age or gender of the participants. Statistical analysis revealed that the preference for the consumption of products and dishes that include soy increases with age. e frequency of the appearance of a general allergy to soy in the population is not known yet. However, it seems that it depends on the exposure to this type of food and on nutritional habits. Soy proteins are widely used in child nutrition products and in highly processed food products. is is why the number of soy allergies is growing [26].
e study revealed that gluten, wheat, cow's milk, eggs, and aromas are among the most frequently occurring allergens and substances that can be potentially harmful for the organism Fig.1. e results correspond to those reached by Sicherer and Samspon. In that study, cow's milk, eggs, peanuts, wheat, soy, nuts, sh, and seafood were among the products that most o en cause allergies among children. It is pointed out that cereal proteins are an important allergen among children [27]. Statistical analysis did not reveal statistically signi cant di erences in relation to the gender or age of the participants and the preference for the consumption of dishes and food products that include wheat, gluten, cow's milk, corn, peanuts, mushrooms, thickeners, leavening agents, and monoglycerides and diglycerides of fatty acids. Perhaps if the group of participants had been larger, statistical signi cance would be achieved and it would show the di erences between the preferences for consumption and age or gender.
Facebook proved to be a reliable tool for the collection of information about the nutritional preferences of children and teenagers. Loshe and Wamboldt also used Facebook in order to collect data for their study, and they considered the social media website a more e ective and more e cient tool in comparison to traditional methods [28].
In the future, a step forward would be to use Facebook in order to educate parents in terms of rational nutrition and psychoeducation.